Flat Feet

What are Flat Feet?

The vast majority of flat feet do not necessarily require any treatment and are not painful particularly those flat feet seen in children.

In children, there are serveral factors we take into consideration when deciding to treat or not to treat.

Generally, we like to establish the following:

• Is pain a factor?
• Age
• Meidcal history
• Is there a family history of flat feet?

Furthermore, flat feet are generally considered developmental up until approximately 7-8 years of age and then after this are considered non-developmental.

However, progressive flat foot deformity or an acquired flat foot deformity is a condition which can present in adults where the tendon and ligaments which support the arch of the foot stretch or give way which causes the arch of the foot to collapse leading to a painful deformity.

This condition will usually affect middle to older age individuals and is more likely to occur in women than men. People with this condition usually already have flat feet. The causes for flat foot deformity are not well understood but contributing factors which may increase the risk of flat foot deformity include diabetes, obesity and hypertension.

There are three stages of the adult acquired flatfoot:

• Stage 1 - Inflammation and swelling of the posterior tibial tendon around the inside of the ankle.

• Stage 2 - Visible deformity comparing one foot to the other, as the symptomatic foot becomes flatter and more deformed. The deformity is movable and correctable in this stage.
• Stage 3 - The foot progresses to a rigid, non-movable flat foot deformity that is painful, primarily on the outside of the ankle

Treatment

If at any time pain is associated with a flat foot it is best to seek treatment as soon as possible.

The stage and severity of flat feet will usually dictate the treatment and management.

Treatment may include one or more of the following interventions:

• Rest
• Activity modification
• Footwear modification
• Strapping
• Over-the-counter (OTC) foot orthoses
• Custom foot orthoses
• Ankle-Foot-Orthoses (AFO)
• Exercise prescription
• Medical Laser

All treatments are individualised so the type of treatment you will receive will also depend on certain factors, such as:

• Age
• Severity
• Activity
• Duration of symptoms

If orthotic therapy is indicated, the type of foot orthoses used to treat your condition will be dependent on the severity and complexity. Some feet may respond well to a pre-fabricated foot orthotic whereas more complex cases that require higher levels of customisation will likely benefit more from a custom foot orthotic.